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119 Cards in this Set
- Front
- Back
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Falciform ligament
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connects liver to anterior abdominal wall
contains the ligamentum teres |
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Ligamentum teres
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fetal remnant of umbilical vein
found in the Falciform ligament |
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Hepatoduodenal ligament
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connects liver to duodenum
contains the portal triad: hepatic artery, portal vein, common bile duct |
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Gastrohepatic ligament
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connects liver to lesser curvature of stomach
contains the gastric arteries |
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Gastrocolic ligament
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connects the greater curvature of the stomach to the transverse colon
contains the gastroepiploic arteries |
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Gastrosplenic ligament
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connects the greater curvature of the stomach to the spleen
does not contain any vessels |
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Splenorenal ligament
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connects the spleen to the posterior abdominal wall
contains the splenic artery and vein |
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Medial umbilical ligaments
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fetal remnant of umbilical arteries
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Ligamentum venosum
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fetal remnant of ductus venosus
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Median umbilical ligament
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fetal remnant of allantois (urachus)
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Myenteric plexus
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aka Auerbach's plexus
coordinates motility along entire gut wall. Located between inner(circular) and outer(longitudinal) layers of smooth muscle in the muscularis externa |
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Auerbach's plexus
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aka Myenteric plexus
coordinates motility along entire gut wall. Located between inner(circular) and outer(longitudinal) layers of smooth muscle in the muscularis externa |
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Submucosal plexus
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aka Meissner's plexus
Regulates local secretions, blood flow and absorption of GI tract Located between mucosa and inner layer of smooth muscle in GI tract wall |
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Meissner's plexus
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aka Submucosal plexus
Regulates local secretions, blood flow and absorption of GI tract Located between mucosa and inner layer of smooth muscle in GI tract wall |
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Brunner's glands
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Secrete alkaline mucus to duodenum
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Indirect hernia
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Goes through deep inguinal ring and superficial inguinal ring
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Direct hernia
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Protrudes through the inguinal(hesselbach's) triangle
Bulges directly through abdominal wall |
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Femoral hernia
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Protrudes through femoral canal below and lateral to pubic tubercle
More common in women |
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Hesselbach's triangle
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area bordered by the inferior epigastric artery (lateral/superiorly), the inguinal ligament (lateral/inferiorly), and the lateral boder of rectus abdominus (medially)
Site of protrusion in a direct inguinal hernia |
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Parietal Cells of stomach
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Secrete Gastric acid(HCl) and intrinsic factor
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Chief cells of stomach
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Secrete pepsinogen which is a precursor to pepsin
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Mucous neck cells of stomach
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Secretes mucus to help protect the gastric mucosa
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Smooth surface cells of stomach
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secrete thick mucus w/ bicarbonate to provide a pH barrier to the gastric mucosa
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Gastrin
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Source: G cells of stomach antrum
Action: Increases gastric H+ secretion, growth of gastric mucosa and gastric motility Regulation: secretion increased by stomach distension, amino acids, peptides, vagal stimulation and decreased by stomach pH <1.5 |
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Cholecystokinin
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Source: I cells of duodenum and jejunum
Action: Increases pancreatic secretion and gallbladder contraction; decreases gastric emptying Regulation: Secretion decreased by secretin and increased by fatty acids, amino acids |
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Secretin
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Source: S cells of duodenum
Action: Increases pancreatic bicarb secretion and decreases gastric acid secretion Regulation: secretion increased by acid, fatty acids in lumen of duodenum |
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Somatostatin
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Source: D cells of pancreatic islets and GI mucosa
Action: Decreases gastric acid and pepsinogen secretion, pancreatic and small intestine fluid secretion, gallbladder contraction, and insulin and glucagon release Regulation: secretion increased by acid, decreased by vagal stimulation |
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GIP
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Gastric inhibitory peptide
Source: K cells of duodenum and jejunum Action: Decreases gastric H+ secretion and increases insulin release Regulation: secretion increased b fatty acids, amino acids, oral glucose |
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VIP
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Vasoactive intestinal polypeptide
Source: Parasympathetic ganglia in sphincters, gall bladder, small intestine Action: Increases intestinal water and electrolyte secretion, relaxation of intestinal smooth muscle and sphincters Regulation: secretion increased by distention and vagal stimulation and decreased by adrenergic input |
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Nitric Oxide
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Action: Increases smooth muscle relaxation, including lower esophageal sphincter
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What hormone is increased in Zollinger-Ellison syndrome
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Gastrin
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Increase in what hormone causes worsening of pain in patients w/ cholelithiasis after fatty food ingestion?
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CCK
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What hormone is used to treat VIPoma and carcinoid tumors
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Somatostatin
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VIPoma
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non-alpha, non-beta islet cell pancreatic tumor that secretes VIP
Results in copious diarrhea |
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alpha-amylase
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starch digestion
Secreted by the Pancreas |
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Lipase
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fat digestion
Secreted by the Pancreas |
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Trypsin
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Protein digestion
secreted as a proenzyme Secreted by the Pancreas |
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Chymotrypsin
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Protein digestion
secreted as a proenzyme Secreted by the Pancreas |
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Elastase
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Protein digestion
secreted as a proenzyme Secreted by the Pancreas |
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Carboxypeptidase
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Protein digestion
secreted as a proenzyme Secreted by the Pancreas |
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Enterokinase
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Duodenal brush border enzyme that converts trypsinogen to trypsin
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Salivary amylase
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starts digestion, hydrolyzes alpha-1,4 linkages to yield disaccharides
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Glucose absorption
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taken up by SGLT1(Na dependent) and GLUT-2
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Oligosaccharide hydrolase
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Intestinal brush border enzyme
RLS in carbohydrate digestion Produces monosaccharides from oligo- and disaccharides |
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Galactose absorption
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taken up by SGLT1(Na dependent) and GLUT-2
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Fructose absorption
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taken up by GLUT-5(Facilitated diffusion) and GLUT-2
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Zone I of liver
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Periportal zone
Area of portal vein and hepatic artery Most sensitive to toxic injury Affected first by viral hepatitis |
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Zone II of liver
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Intermediate zone in between portal vein and central vein
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Zone III of liver
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Pericentral vein zone
Contains P-450 system Affected first by ischemia |
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Celiac sprue a/w ____?
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a/w T cell lymphoma and dermatitis herpetiformis
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Tropical sprue
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Malabsorption syndrome
Probably infectious Responds to antibiotics Can affect entire small bowel |
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Organism in Whipple's Disease?
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Infection w/ Tropheryma whippelii
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Acute gastritis
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erosive inflamation of the stomach
caused by stress, NSAIDs, alcohol, uricemia, burns(curling's ulcer), and brain injury(cushing's ulcer) |
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Type A chronic gastritis
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nonerosive inflamation of the stomach fundus/body
Autoimmune w/ autoantibodies to parietal cells, pernicious Anemia, and Achlorhydria |
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Type B chronic gastritis
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nonerosive inflammation of the stomach antrum
caused by H. pylori infection Increased risk of MALT lymphoma |
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Most common stomach cancer?
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Adenocarcinoma
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What is linitus plastica
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diffusely infiltrative stomach cancer w/ thickened, rigid appearance
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Krukenberg's tumor
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bilateral metastases of stomach cancer to ovaries
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Crohn's or ulcerative colitis:
terminal ileum and colon |
Crohn's disease
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Crohn's or ulcerative colitis:
skip lesions |
Crohn's disease
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Crohn's or ulcerative colitis:
"string sign" on barium swallow x-ray |
Crohn's disease
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Crohn's or ulcerative colitis:
can lead to fistulas |
Crohn's disease
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Crohn's or ulcerative colitis:
a/w migratory polyarthritis |
Crohn's disease
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Crohn's or ulcerative colitis:
a/w erythema nodosum |
Crohn's disease
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Crohn's or ulcerative colitis:
a/w ankylosing spondylitis |
Crohn's disease
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Crohn's or ulcerative colitis:
rectal sparing |
Crohn's disease
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Crohn's or ulcerative colitis:
continous lesions |
Ulcerative colitis
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Crohn's or ulcerative colitis:
Rectal involvement |
Ulcerative colitis
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Crohn's or ulcerative colitis:
Transmural inflammation |
Crohn's disease
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Crohn's or ulcerative colitis:
Mucosal and submucosal inflammation only |
Ulcerative colitis
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Crohn's or ulcerative colitis:
Mucosal pseudopolyps |
Ulcerative colitis
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Crohn's or ulcerative colitis:
a/w colorectal carcinoma |
Ulcerative colitis
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Crohn's or ulcerative colitis:
can lead to toxic megacolon |
Ulcerative colitis
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Crohn's or ulcerative colitis:
a/w pyoderma gangrenosum |
Ulcerative colitis
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Crohn's or ulcerative colitis:
a/w primary sclerosing cholangitis |
Ulcerative colitis
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Meckel's diverticulum
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Persistance of the vitelline duct or yolk stalk
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tumor marker for colorectal cancer
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CEA
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APC gene
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chromosome 5q
leads to familial adenomatous polposis |
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Mallory bodies
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intracytoplasmic eosinophilic inclusions in liver
a/w alcoholic hepatitis |
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AST>ALT
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Alcoholic hepatitis
ratio usually > 1.5 |
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ALT>AST
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Viral hepatitis
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only AST increased
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Myocardial infarction
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Increased alkaline phosphatase
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Obstructive liver disease (hepatocellular carcinoma) and bone disease
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Increased amylase and lipase
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Acute pancreatitis
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Decreased ceruloplasmin
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Wilson's disease
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Kayser-Fleischer rings
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Corneal deposits of copper
Wilson's disease |
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Hemochromatosis a/w HLA ____?
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HLA A3
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Abesnt UDP-glucuronyl transferase
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Crigler-Najjar syndrome, type I
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Conugated hyperbilirubinemia w/ grossly black liver
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Dubin-Johnson syndrome
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Intra- and extrahepatic defect of bile ducts
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Primary sclerosing cholangitis
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"Beading" on ERCP
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Primary sclerosing cholangitis
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Intrahepatic defect of bile ducts
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Primary Biliary Cirrhosis
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Autoimmune disorder leading to obstructive jaundice
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Primary Biliary Cirrhosis
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Mitochondrial antibodies
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Primary Biliary Cirrhosis
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Primary Biliary Cirrhosis is a/w what?
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scleroderma and CREST syndrome
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Extrahepatic defect of bile ducts
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Secondary Biliary Cirrhosis
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Complications of Secondary Biliary Cirrhosis?
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ascending cholantitis (bacterial infection), bile stasis, and "bile lakes"
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Most common primary malignant tumor of liver
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Hepatocellular carcinoma
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Tumor marker for Hepatocellular Carcinoma
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alpha-fetoprotein
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Viruses a/w Reye's syndrome
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VZV and influenza B
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Most common type of Gallstone
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Mixed stone- both cholesterol and pigment components
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Type of Gallstone a/w:
Crohn's disease |
Cholesterol stone
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Type of Gallstone a/w:
Cystic Fibrosis |
Cholesterol stone
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Type of Gallstone a/w:
Native Americans |
Cholesterol stone
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Type of Gallstone a/w:
Estrogens |
Cholesterol stone
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Type of Gallstone a/w:
Rapid weight loss |
Cholesterol stone
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Type of Gallstone a/w:
Chronic RBC hemolysis |
Pigment stone
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Type of Gallstone a/w:
Alcoholic cirrhosis |
Pigment stone
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Type of Gallstone a/w:
Biliary infection |
Pigment stone
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Lab values in acute pancreatitis
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Increased amylase and lipase
Lipase is more specific |
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Chronic calcifying pancreatitis is a/w what?
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Alcoholism
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Chronic obstructive pancreatitis is a/w what?
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Gallstones
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What type of cancer forms in the pancreas?
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Adenocarcinoma
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Prognosis for Pancreatic adenocarcinoma
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averages 6 months of less
Patient usually has metastases by the time of presentation |
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What individuals are a/w increased risk of pancreatic adenocarcinoma
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Jewish and African-American males
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Courvoisier's sign
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Obstructive jaundice w/ palpable gallbladder
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Trousseau's syndrome
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Migratory thrombophlebitis
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Pancreatic adenocarcinoma is a/w use of what?
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cigarettes
pancreatic adenocarcinoma is not a/w EtOH |
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Symptoms of Carcinoid
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Wheezing, right-sided heart lesions, diarrhea, flushing
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